The move to reduce overprescribing of painkilling drugs covers pills containing hydrocodone, which is more widely dispensed in the U.S. than cholesterol and blood pressure medications.
In an effort to reduce the widespread abuse of narcotic painkilling drugs in the U.S., the Food and Drug Administration has recommended imposing far more severe restrictions, including an education program that zeros-in on reducing the misuse and misprescribing of opioids.
The decision by the federal agency follows a recommendation given to it by an advisory committee, which voted 19-10 to limit the amount of such medicines that can be prescribed without a new prescription. The move covers pills containing hydrocodone.
Hydrocodone is more widely dispensed in the U.S. than even cholesterol and blood pressure medications. But since it is commonly sold as a generic drug, hydrocodone makes up just a fraction of the fast-growing $7.3 billion pain market.
Key elements of the plan—called Epidemic: Responding to America’s Prescription Drug Abuse Crisis—include:
- Expansion of state-based prescription drug monitoring programs
- Recommending convenient and environmentally responsible ways to remove unused medications from homes
- Supporting education for patients and health care providers
- Reducing the number of “pill mills” and doctor-shopping through law enforcement
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A study found that nearly a third of patients age 65 and older who are referred to a specialist end up not seeing that specialist.
The most frequent error in medicine seems to occur nearly one out of three times a patient is referred to a specialist. A study found that nearly a third of patients age 65 and older referred to a specialist are not scheduled for appointments and therefore do not receive the treatment their primary care doctor intended.
According to a study in the Journal of Evaluation in Clinical Practice, only 71 percent of patients age 65 or older who are referred to a specialist are actually scheduled to be seen by that physician. Furthermore, only 70 percent of those with an appointment actually went to the specialist’s office.
Thus, only 50 percent (70 percent of 71 percent) of those referred to a specialist had the opportunity to receive the treatment their primary care doctor intended them to have, according to the findings by researchers from the Regenstrief Institute and the Indiana University School of Medicine. Read more
New provision is aimed to decrease the number of extended observation stays, while decreasing the number of short inpatient stays billed under Part A that should be billed under Part B as outpatient services.
Question: Why does CMS want to decrease the number of extended observation stays?
Answer: Extended observation stays have a negative impact on beneficiaries since they require a 20 percent co-pay for the service and do not count towards the 3 inpatient day stay required for Medicare coverage skilled nursing facility (SNF) admissions.
The Centers for Medicare & Medicaid Services released its controversial “2 midnights” rule in the 2014 Medicare Inpatient Prospective Payment System (IPPS) final rule.
Under the “2 midnights” rule CMS has set both a benchmark and a presumption for when an inpatient satay would be considered appropriate. If the inpatient stays spans two midnights, CMS will presume that the stay is reasonable and necessary. In addition, admitting clinicians can use the “2 midnight stay” as a benchmark in determining when it is appropriate to admit a patient as an inpatient rather than keeping the patient in an outpatient status in an observation unit. Read more